Active NPI
Colin Robert Bettis, LCSW
- Social Worker
- Eureka, CA
National Provider Identifier
1730446113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 141510
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 268-2990
- NPI assigned
- Apr 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | 141510 | CA | Primary |
| Counselor | 101Y00000X | 108972 | CA |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
720 Wood St
Eureka, CA 95501-4413
Phone (707) 268-2990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108972 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1730446113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 WOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014413",
"telephone_number": "707-268-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014413",
"telephone_number": "707-268-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETTIS",
"first_name": "COLIN",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-23",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "141510",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "108972",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.